PCR detection of Toxoplasma gondii DNA in CSF for the differential diagnosis of AIDS-related focal brain lesions

Antonella Cingolani, Andrea De Luca, Adriana Ammassari, Rita Murri, Angela Linzalone, Rita Grillo, Andrea Antinori

Research output: Contribution to journalArticle

Abstract

To evaluate whether the detection of Toxoplasmosis gondii DNA in CSF could contribute to the differential diagnosis of AIDS-related focal brain lesions, CSF samples from 88 HIV-infected patients (56 with focal brain lesions and 32 without) were tested prospectively by a nested PCR for the B1 gene of T. gondii. The assay had a detection limit of 10 trophozoite equivalents. Six of 18 patients with toxoplasmic encephalitis, but none of the 70 patients with other disorders, were PCR-positive (33.3% sensitivity and 100% specificity). Considering only those patients with cerebral toxoplasmosis from whom CSF was collected before or during the first week of antitoxoplasmic therapy, sensitivity rose to 50%. This was higher than the sensitivity in patients whose CSF was collected after the first week of treatment (odds ratio (OR) of 7.0; 95% CI: 0.46-218.2). The administration of antitoxoplasmic prophylaxis did not affect the PCR results. Patients with a poor response to therapy had a higher probability of detectable T. gondii DNA in their CSF (OR of 5.0; 95% CI: 0.37-86.6). All patients with other central nervous system disorders were PCR-negative. Despite the moderate sensitivity, the high specificity and positive predictive value (100%) make this assay a useful tool in the differential diagnosis of AIDS-related focal brain lesions as part of a series of CSF and neuroradiological examinations.

Original languageEnglish
Pages (from-to)472-476
Number of pages5
JournalJournal of Medical Microbiology
Volume45
Issue number6
Publication statusPublished - 1996

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Toxoplasma
Acquired Immunodeficiency Syndrome
Differential Diagnosis
Polymerase Chain Reaction
DNA
Brain
Odds Ratio
Cerebral Toxoplasmosis
Trophozoites
Central Nervous System Diseases
Toxoplasmosis
Encephalitis
Limit of Detection
Therapeutics
HIV
Sensitivity and Specificity
Genes

ASJC Scopus subject areas

  • Microbiology
  • Microbiology (medical)

Cite this

PCR detection of Toxoplasma gondii DNA in CSF for the differential diagnosis of AIDS-related focal brain lesions. / Cingolani, Antonella; De Luca, Andrea; Ammassari, Adriana; Murri, Rita; Linzalone, Angela; Grillo, Rita; Antinori, Andrea.

In: Journal of Medical Microbiology, Vol. 45, No. 6, 1996, p. 472-476.

Research output: Contribution to journalArticle

Cingolani, Antonella ; De Luca, Andrea ; Ammassari, Adriana ; Murri, Rita ; Linzalone, Angela ; Grillo, Rita ; Antinori, Andrea. / PCR detection of Toxoplasma gondii DNA in CSF for the differential diagnosis of AIDS-related focal brain lesions. In: Journal of Medical Microbiology. 1996 ; Vol. 45, No. 6. pp. 472-476.
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